When I came to US and went to see a doctor for my condition (I even told here I was PCOS), the first thing she did was to order a lot of blood work. I am sure all fertility tests begin with the blood work. Just like everyone, I had no clue what these levels were. Even though there was a chart in the blood work that says the normal value ranges, I was still confused as my levels were either lower or elevated than normal. I couldn’t comprehend what the higher/lower levels meant.
This can be really frustrating because in most cases, doctors also do not really say much about what the lower/higher levels mean. So I started reading on the net and found some answers though not all. In this post, I want to share the details of the normal ranges and what a deviation from normal means.
Ok, there are several vials of blood taken from you on the Day 3 of your cycle. This stage is called the follicular phase and the levels are termed ‘Follicular Phase levels’. Later some more tests are done on Day 7 of your cycle, which is called the mid cycle phase and usually LH is checked at the surge period (Days 13 to 15) to check for ovulation.
These values are the average normal ranges and the ranges may differ from lab to lab. These values are presented just for the reference purposes so that you can better know about the hormone levels and ask your doctor precisely about the doubts that you may have. These values must not be used for self diagnosis or treatment.
|Hormone||Day||Normal range||What does a lower level mean?||What does an elevated level mean?|
|FSH||Day 3||3-20 mIU/ml||This test is done to find out the ovarian reserve. |
<6 – very good
6-9 – Good
9-10 – fair
|10-13 – diminished reserve |
>13 – very hard to stimulate
|Estrodiol (E2)||Day 3||25-75 pg/ml||Lower levels are better for stimulation||Very high values may indicate a low ovarian reserve or that a cyst is already present|
|LH||Day 3||<7 mIU/ml||Higher value of LH (meaning a higher LH:FSH ratio) indicates PCOS condition|
|Prolactin||Day 3||<24 ng/ml||Higher levels in this test are usually followed by a MRI to test for pituitary tumor. High value of prolactin discourages ovulation|
|Progesterone||Day 3||<1.5 ng/ml||Lower levels occur in PCOS. Several fertility supplements and progesterone patches are available to correct this||Low pregnancy rate|
|Thyroid Stimulating Hormone (TSH)||Day 3||0.4-4 uIU/ml||Indicative of hypothyroidism and this directly affects fertility|
|Free Triiodothyronine (T3)||Day 3||1.4-4.4 pg/ml||A disease affected thyroid gland may produce high levels of T3. But the thyroid function cannot be defined just by this. T4 levels must also be considered.|
|Free Thyroxine (T4)||Day 3||0.8-2 ng/dl||A nonfunctional thyroid gland or a nonfunctional pituitary gland which has to stimulate the thyroid gland. A low T4 and normal TSH points to a pituitary problem|
|Total Testosterone||Day 3||6-86 ng/dl||Values greater than 50 are usually considered elevated levels|
|Free Testosterone||Day 3||0.7-3.6 pg/ml||Higher values are another indication of PCOS|
|DHEAS||Day 3||35-430 ug/dl||Elevated values are seen in PCOS condition. Insulin-sensiting medications are prescribed for correcting this.|
|Androstenedione||Day 3||0.7-3.1 ng/ml|
|Sex Hormone Binding Globulin (SHBG)||Day 3||18-114 nmol/l||Higher androgen levels are responsible for lower SHBG levels|
|17 Hydroxy progesterone||Day 3||20-100 ng/dl|
|Estradiol (E2)||Day 5||100+ pg/ml |
2 times value of Day3
|Lower values indicate anovulatory cycle|
|Estradiol (E2)||Surge Day||200+ pg/ml |
(200-600 per a follicle of 18mm size)
|Obesity can cause a lower value|
|LH||Surge Day |
(usually 13 to 15)
|>20 mIU/ml |
(ovulation occurs in 36-48 hrs)
|No surge indicates anovulatory cycle|
|Progesterone||7 days post ovulation||>15 ng/ml||>5 indicates ovulation |
in normal cycle, it is expected to be >10 and in medicated cycles, the value is expected to be >15
There are several other tests that are taken when one goes for a fertility treatment. I am going to write about those tests and what they mean in my future posts.
I hope these info helps at least in a small way.
Have I missed any hormone values? Do you have more information on the hormone levels from your doctor? Please share them in the comments.